Health
Background
Good health is one of the most important things to people and also brings many other benefits, including enhanced access to education and the job market, an increase in productivity and wealth, reduced health care costs, good social relations, and of course, a longer life.
Life expectancy
Life expectancy is the most widely used measure of health, although it only takes into account the length of people’s life and not their quality of life. There have been remarkable gains in life expectancy over the past 50 years in OECD countries. On average, life expectancy at birth reaches 81 years across OECD countries, a gain of more than 11 years since 1960. Women live about five years longer than men, averaging 83.6 years versus 78.3 years for men. The OECD country with the highest life expectancy is Japan with an average life expectancy of 84 years. At the other end of the scale, life expectancy is the lowest in Mexico, at 75 years. Life expectancy in Brazil stands at 76 years, 73 years in the Russian Federation and 64 years in South Africa.
Recent OECD analysis suggests that health care spending growth has contributed to the improvement in life expectancy, but other determinants such as rising living standards, environmental improvements, lifestyle changes and education are also important drivers. Taken together, these explain much of the cross-country differences in life expectancy, as well as changes over time. Further progress in population health status and life expectancy can be achieved by putting greater emphasis on public health and disease prevention, especially among disadvantaged groups, and by improving the quality and performance of health care systems.
Chronic (non-communicable) diseases including cancer, cardiovascular diseases, chronic respiratory conditions and diabetes, are now the main causes of disability and death in OECD countries. Many of these diseases are preventable, since they are linked to modifiable lifestyles. People who do not smoke, drink alcohol in moderate quantities, are physically active, eat a balanced diet, and who are not overweight or obese have a much lower risk of early death than those who have unhealthy habits.
Self-reported health
Most OECD countries conduct regular health surveys which allow respondents to report on different aspects of their health. The commonly-asked question, "How is your health?" is one way of collecting data on self-perceived health status. Despite the subjective nature of this question, the answers received have been found to be a good predictor of people's future health care use. Across the OECD, about 68% of the adult population say their health is "good" or "very good". In Canada and the United states, 88% of adults report being in good health; while in Japan and Korea, despite very high life expectancies, less than 40% of people rate their health as "good" or "very good". Cultural and framing factors may affect responses to this broad question on health status.
Men are more likely to report good health than women, with an OECD average of 71% of men saying their health is "good" or "very good" compared with 66% for women. The gap is largest in the Russian Federation, Portugal and Latvia. Age and social status also have an impact on answers. Not surprisingly, older people report poorer health, as do those who are unemployed, or who have less education or income. About 79% of adults with a disposable income in the top 20% across OECD countries rate their health as "good" or "very good", compared to about 58% for those with a disposable income in the bottom 20%.
Health in Detail by Country
lva Health - Latvia expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Latvia stands at almost 76 years, five years below the OECD average of 81 years and one of the lowest in the OECD. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked "How is your health in general?" 47% of people in Latvia reported to be in good health, much less than the OECD average of 68%. Caution is required in making cross-country comparisons as the assessment can be affected by factors as cultural background. Despite the subjective nature of this question, answers have been found to be a good predictor of people’s future health care use. Gender, age and social status may affect answers to this question.
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aus Health – Australia expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Australia stands at 83 years, two years above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors (such as living standards, lifestyles, education and environmental factors have an impact on life expectancy).
When asked, "How is your health in general?" around 85% of people in Australia said they were in good health, more than the OECD average of 68%. Despite the subjective nature of this question, answers have also been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Mental health services for youth
Mental health problems are more likely to occur in adolescence than later in life. Australia has initiated a number of youth-focused mental health programmes to reach this demographic.
Headspace centres provide mental health and well-being support to young people between 12 and 25 years old. These centres function as integrated service hubs where youth can access social workers, psychologists, drug and alcohol workers, job counsellors and health professionals. Anyone can walk in to ask for help and most services are provided for free. A recent study found that one-third of Headspace clients are not in education, training or employment and that over half presented very high levels of psychological distress. It is not yet clear which services are the most used, however the programme shows potential for preventing school dropouts. Around 100 centres are open across Australia.
Orygen Youth Health offers vocational services in parallel to health services to young people suffering from first-episode psychoses, mood disorders or personality disorders. Participants can attend a Psychosocial Recovery Programme, as well as a Group Programme, to help re-integrate them in school, training or employment. Early results show that this integrated approach is more effective than health intervention alone, with 85% of clients moving to education or employment, compared to 29% in the control group.
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aut Health – Austria expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Austria stands at 82 years, one year above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyle, education and environmental factors).
When asked, "How is your health in general?" just above 71% of people in Austria reported to be in good health, higher than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Elderly care services
Long-term care is a major policy priority in Austria. Increasing longevity and declining fertility rates are expected to double old-age dependency ratios to reach 50% by 2060. This requires diversity in care options to help families, particularly women, better manage work and care responsibilities. Today, nearly four fifths of the elderly are cared for in family environments.
Families receive support through long-term care cash benefits, care leave and 24-hour care aid. Recent reforms have streamlined the process of receiving long-term care cash benefits. It is expected these changes will increase procedural transparency, ensure inter-regional equity among dependents and improve efficiency and financial sustainability.
Complementary services such as nursing homes and post-hospital care are also available. They are offered by public and private providers, on a non-profit or commercial basis, and publicly subsidised at differing degrees. Alternative living facilities and case and care management arrangements need to be developed to meet a growing demand for care. Currently, residential care facilities and alternative living facilities are not a sufficient substitute or complement to home care for those in need.
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bel Health – Belgium expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Belgium stands at 82 years, one year above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked, "How is your health in general?" almost 74% of people in Belgium reported to be in good health, higher than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
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bra Health – Brazil expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Brazil stands at almost 76 years, five years below the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
Better Policies for Better Lives
Improving hospital management
Sao Paulo has set up a performance-based contracting arrangement between the government health system and a private non- profit management group, OSS, to improve hospital management. The state negotiates a performance contract with the OSS that provides a global budget to manage the hospitals, and the OSS commits to specific volume and performance targets. The OSS managers are granted greater flexibility than their counterparts in traditional state hospitals to run the hospital in the best way to meet their performance targets.
The initiative aimed to provide high quality inpatient services at reasonable cost in more vulnerable communities located outside of the São Paulo metropolitan area. The programme was accompanied by construction of 37 new hospitals, which increased access to inpatient care by expanding services to 5.2 million inhabitants.
External reviews show that OSS-managed hospitals appear to be more efficient and also more productive than their counterparts. Another evaluation concluded that while hospitals managed by OSS received on average 8% more revenues than directly administered hospitals, they also produced a higher volume of services than their counterparts, resulting in a 24% lower cost per bed day than publicly managed hospitals.
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can Health – Canada expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Canada stands at 82 years, one year above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked, "How is your health in general?" almost 89% of people in Canada reported to be in good health, much more than the OECD average of 68% and one of the highest scores across the OECD. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Monitoring the quality of long-term care
In Ontario, Canada's largest province in size of population, the government monitors the quality of long-term care (LTC). They look at accessibility, effectiveness, safety, and resource appropriateness. Access is measured through length of time waiting for nursing-home placement and the percentage of those who are placed in their first-choice LTC home.
Effectiveness is monitored by a set of health outcome indicators such as the percentage of LTC recipients with worsening symptoms of depression. Safety is presented by the number of LTC recipients prescribed a drug that should be avoided, and the percentage of LTC recipients started on certain drugs (such as antipsychotics) without clear reason. Resource appropriateness is measured by the expenditure as a percentage of GDP.
Promoting drug safety
Health Canada launched a public consultation to develop guidelines that effectively meet the needs of Canadians. The guidelines support the implementation of the Protecting Canadians from Unsafe Drugs Act. Health Canada used Twitter to facilitate consultations and find out more about what Canadians need when seeking information about drug safety. From this, the new Guide to New Authorities set out standards, policies and principles to support the implementation of the Act. These guidelines are available to industry, researchers and the public.
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chl Health – Chile expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Chile stands at almost 81 years, in line with the OECD average. Higher life expectancy is generally associated with higher health care spending per person, although many other factors such as living standards, lifestyles, education and environmental factors have an impact on life expectancy.
When asked, "How is your health in general?" almost 60% of people in Chile reported to be in good health, less than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Faster treatment for patients
The Bono Auge programme (launched in 2010) reduces long waiting lists in public hospitals and ensures fast treatment for publicly insured patients in case of high risk diseases. The programme establishes a system of universal access and explicit guarantees for health care services by law. It means that people can obtain health care in the private sector via a voucher (bono) if public care is not available. The programme sets a maximum time limit to get medical attention to patients with one of 80 high-mortality pathological conditions. Patients who do not get prompt treatment in a public facility will be assigned to a different, public or private, provider through a Bono Auge voucher within two days.
The programme has led to a reduction of the patient waiting list with 113 566 unfulfilled guarantees at the end of 2010 being reduced to 50 780 cases by June 2011, with all cases solved and the list completely eliminated by October 2011. Among patients, 65% said they were satisfied with the benefits delivered by the programme and 81% were satisfied with the medical services provided.
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cze Health – Czechia expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in the Czechia is just above 79 years, two years below the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyle, education and environmental factors).
When asked "How is your health in general?" 62% of people in the Czechia reported to be in good health, less than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
High patient satisfaction with doctors
The Czechia scores very highly in patient experience of visiting doctors. Around 95% of patients report being satisfied that their regular doctor spent enough time with them in the consultation, gave easy-to-understand explanations and gave opportunities to ask questions or raise concerns – among the highest reported rates from OECD countries. However, routine monitoring of patient experiences at sub-national level, by clinic or by hospital, is not systematically performed, and a more rigorous approach, requiring all providers to show how they have measured and responded to service users' feedback is needed here.
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dnk Health – Denmark expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Denmark stands at just above 81 years, in line with the OECD average. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked, "How is your health in general?" just above 70% of people in Denmark reported to be in good health, more than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Digitising health records
Denmark provides a good example of the successful implementation of a national electronic health records system. Widely used by primary care physicians, electronic health records are linked nationally allowing physicians to communicate directly with health care providers. The transition to electronic health care was phased in gradually until MedCom, an independent non-profit organisation, was established to oversee and expand the programme. To deter the creation of parallel or incompatible information systems, a single electronic form was created for all communications from primary care physicians. The consolidation of health care information system governance has also facilitated the effective use of data, and improved the co-ordination of activities and goals across central and regional authorities.
Promoting a healthy diet
A policy initiative to promote a healthy lifestlye and encourage customers to buy more vegetables was introduced in 12 Danish supermarkets over 2015-16. Packs of pre-cut vegetables were placed beside minced meat to encourage people to add them to their meal. The idea that the simple exposure of a healthier option beside regular purchases is based on previous behavioural studies showing that the type of meat people pick in the cold counter often impacts the rest of the meal. The initiative produced very positive results, with a 61.3% increase in the purchase of pre-cut vegetables per customer, with the sales of minced meat also rising, by 32%, suggesting that people will eat a more balanced meal as long as the options are made easily and readily available.
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est Health – Estonia expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Estonia stands at almost 79 years, two years below the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked, "How is your health in general?" just above 56% of people in Estonia reported to be in good health, much less than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
National focus on health
Estonia has reduced out-of-pocket payments, which will help low income households and protect the chronically ill. From January 2015 onwards, the Estonian Health Insurance Fund will reimburse 50% of patients' expenditure on reimbursable medicines exceeding EUR 300 per year. The Fund will reimburse 90% of the cost for patients whose expenditure exceeds EUR 500 per year.
Several measures have been taken to promote generics and affordable drugs. Doctors are now obliged to prescribe medicines by generic name while pharmacists are obliged to offer patients the cheapest available option. An electronic prescription database has been established to monitor compliance. This new system ensures patients receive the best and most affordable option.
Going digital for better healthcare
As part of a broader e-health strategy, Estonia launched e-prescription services which are integrated in a platform that also includes electronic health records, a digital image archive, a patient portal, and e-laboratory and e-emergency care solutions. The e-prescription system allows physicians to send prescriptions to a national database that is accessible to pharmacies, other physicians and the health insurance fund. Patients are able to pick up their medications at any pharmacy by simply showing their ID card. Since refills can be issued via email or through a phone call, patients have reduced the number of visits they make to the doctor, allowing doctors to focus attention to necessary visits.
By 2011, 84% of all prescriptions were issued digitally and over 90% of patients were satisfied with the service. The shift to e-prescriptions also benefited pharmacies by minimising their administrative workload, as well the efficiency of the Estonian health insurance fund. Staff costs related to incorrect prescriptions reduced by more than 90% between 2009 and 2015, resulting in significant savings for the health fund.
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fin Health – Finland expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Finland stands at 82 years, one year above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked, "How is your health in general?" 68% of people in Finland reported to be in good health, in line with the OECD average. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Government actions to reduce high suicide rates
Since the 1980s, consecutive governments have taken the high rates of suicide in Finland seriously by implementing large-scale national prevention programmes. The first national suicide prevention programme was carried out through cross-sector collaboration, including different service sectors and key domains. The findings of this study, which indicated in particular that the risk of suicide was particularly high among young men, aged 15 to 29, led to the establishment of a “Time Out! Back on track” initiative that targeted to this group. This initiative has shown positive results and is still in place in over a hundred municipalities, reaching approximately 60% of men in the target age group. These strategies have been successful in reducing suicide rates and having an associated positive impact on society. Finland has seen a significant drop in suicide rates over the past 25 years, with 40% fewer suicides amoung young men between 1990 and 2013. This brought down the number of suicides from over 50 per 100 000 among young men in 1990 to less than 25 in 2013.
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fra Health – France expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in France stands at 83 years, two years above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked, "How is your health in general?" 67% of people in France reported to be in good health, slightly lower than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Lean hospitals for better service delivery
France launched a number of performance projects in 2009 to improve the quality of service, global efficiency and working conditions in hospitals. These projects promote participative management and are results-oriented. Following the success of a pilot conducted in a training hospital in Nancy performance projects have been rolled out in hospitals across France.
The increased involvement of medical and paramedical staff and reduced number of tasks has lowered the average emergency room waiting time by 28%. Operating room occupancy rates have also increased by 20% thanks to the optimisation of technical equipment and better monitoring. Staff have also reviewed their processes to remove inefficiencies and improve the functioning of daily services. The introduction of participative management has also encouraged communication and collaboration between staff. Together these changes have improved the quality of patient experiences.
Helping people with chronic illness
The Sophia programme offers support for people suffering from chronic illnesses. The services are completely free of charge and provide access to nurses who answer questions, inform patients and help them find concrete solutions to living with their illness, as well as information via a website, e-mails, brochures and newsletter.
Some 820 000 people have joined the programme.
An independent evaluation of the pilot showed net savings, with the cost of the programme more than offset by a decrease of hospital spending. Patients appreciated the advice given by the nurses and said the service helped them change their behaviour.
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deu Health – Germany expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Germany stands just above 81 years, in line with the OECD average. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyle, education and environmental factors).
When asked, "How is your health in general?" nearly 66% of people in Germany reported to be in good health, less than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Disability benefits in Germany
In Germany, roughly 1.6 million people received disability benefits in 2011, compared to 1.9 million in 2000. To raise employment of individuals with disabilities, Germany introduced temporary disability benefits which are reassessed at periodic intervals. Benefits are determined by the person’s labour income during the five years prior to disability. Spending on activation measures for disabled people is higher than in most other OECD countries, reaching 0.3% of GDP. Workers with health problems are entitled to receive assistance from their employers, such as an adapted workplace, preferential selection and support for training, and part-time employment. As a result, the employment rate of disabled people in Germany is one of the highest among OECD countries. Disability benefit recipients continue to automatically acquire public pension claims as if they continued working until reaching the pensionable age.
In 2014, the government slightly increased old-age pension entitlements for disability benefit recipients and benchmark age for accumulating public pension claims for disability benefit receivers was raised from 60 to 62. Starting in 2018 the benchmark age will gradually be increased further to 65 years until 2024 which will further increase the old-age pension entitlements for new disability benefit recipients. Moreover, the period of earnings prior to disability was shortened for the calculation of the disability benefit if it is more favourable to the person applying for benefits.
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grc Health – Greece expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Greece is almost 82 years, slightly higher than the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked, "How is your health in general?" 79% of people in Greece reported to be in good health, more than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
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hun Health – Hungary expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Hungary stands at just above 76 years, five years below the OECD average of 81 years, and one of the lowest in the OECD. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked, "How is your health in general?" 58% of people in Hungary reported to be in good health, less than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
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isl Health – Iceland expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Iceland is just above 83 years, two years above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked, "How is your health in general?" 77% of people in Iceland reported to be in good health, more than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Real-time quality indicators
The emergency department in Landspitali University Hospital uses real-time indicators to track quality, safety and operational efficiency. By continuously gathering and displaying data, hospital staff identify issues as they arise. Some of the indicators examined include: waiting times, numbers of patients, service times, admittance rates, and blood sample hemolytic rates, among others.
Since the introduction of this practice the hospital has experienced lasting improvements. Over 18 months blood sample defects dropped from 12% to 3%. This has reduced patient waiting time in hospital by 90 minutes. The use of real-time indicators has also helped staff better monitor triage, waiting times, and the time it takes to admit a patient.
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irl Health – Ireland expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Ireland stands at almost 83 years, two years above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked, "How is your health in general?" almost 84% of people in Ireland reported to be in good health, more than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
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isr Health – Israel expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Israel stands at almost 83 years, two years above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors such as living standards, lifestyles, education and environmental factors have an impact on life expectancy.
When asked, "How is your health in general?" just below 74% of people in Israel reported to be in good health, more than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Reforming hospital payments
Israel has been moving from daily allowances towards case-based financing of public hospital payments following a payment reform initiated in 2002 to strengthen public hospitals. The new payment system is based on procedures instead of calculations. Patients are clustered into groups (procedure related groups – PRG) according to the procedures performed in the course of their treatment. By 2012, 280 RPGs had been defined with set individual PRG prices. The case-based system is, however, only used for interventional procedures, while the daily allowance system remains in place for non-interventional ones. The gradual introduction of the new policy and the involvement of all stakeholders from the outset likely contributed to the popularity of the reform.
As a result of these changes the share of PRG payments in total hospital revenues increased from 16% to 23% between 2003 and 2012, while the share of daily allowances fell from 47% to 39% during the same period. Although no systematic evaluation of the reform has been carried out yet, data collected by the Ministry of Health shows that the PRG has generated efficiency gains, as the average length of stay at hospitals has gone down. However, PRGs will have to be developed further to the severity of the patient’s condition into account.
Quality indicators in community health care
Quality Indicators in Community Healthcare (QICH) is a national monitoring system that evaluates community care. The indicators examine six primary care areas including: asthma; cancer screening; immunisation for older adults; child and adolescent health; cardiovascular health; and diabetes. The continuous evaluation of data around clinical performance shows patients and practitioners how different communities compare.
There have been noticeable improvements in the quality of care for diabetes since the programme was introduced. Between 2004 and 2009 poor HbA1c control fell by 29% and control of cholesterol increased by 96.2%. Success factors include QICH's robust scientific basis; involvement of practitioners and health insurance companies in the development of the indicators; clear patient-oriented objectives; and systematic and continuous feedback of comparative data to both professionals and the public.
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ita Health – Italy expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Italy stands at almost 84 years, three years above the OECD average of 81 years, and one of the highest in the OECD. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked, "How is your health in general?" almost 73% of people in Italy reported to be in good health, above the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Improving regional health systems
Italy's National Agency for Regional Health Services (AGENAS) co-ordinates different levels of government to address regional differences in care and outcomes. AGENAS' Observatory for Good Practices for Patient Safety collects, classifies, and disseminates safety improvement activities to regions and autonomous provinces. Every year the Observatory issues a call for good practices to encourage patient safety. In this call it provides a standard platform through which to report content, outcomes and costs to ensure comparability. Examples of good practices are then shared in an annual publication and database. Chosen practices show a clear evidence base, are sustainable and are evaluated in accordance with the principles of Continuous Quality Improvement. The Observatory's success in co-ordinating action between the Italian health regions is attributed to the early inclusion of stakeholder input in its design. Complementary top-down and bottom-up actions have also helped sustain collaboration.
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jpn Health – Japan expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Japan enjoys one of the highest life expectancies among OECD countries at just above 84 years, three years above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked "How is your health in general?" only around 37% of people in Japan reported to be in good health, much less than the OECD average of 68%, and one of the lowest scores in the OECD. Caution is required in making cross-country comparisons as the assessment can be affected by factors as cultural background. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
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kor Health – Korea expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth is just above 83 years, two years above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked "How is your health in general?" almost 34% of people in Korea reported to be in good health, much less than the OECD average of 68% and the lowest score in the OECD. Caution is required in making cross-country comparisons as the assessment can be affected by factors as cultural background. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
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lux Health – Luxembourg expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Since 1960, life expectancy at birth in Luxembourg increased by more than 11 years. Life expectancy at birth in Luxembourg now stands at almost 83 years, two years above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked, "How is your health in general?" 72% of people in Luxembourg reported to be in good health, higher than the OECD average of 68%. Caution is required in making cross-country comparisons as the assessment can be affected by factors as cultural background. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Monitoring standards in long-term care
The Luxembourg government sets minimum standards for structural and organisational quality for residential care providers.
The government has also set up a quality commission to regulate the provision of services under long-term care insurance, with qualification standards and guidelines for good practices. There are follow-up visits to evaluate if providers meet the framework. Compliance with the contractual agreement is checked at least one a year.
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mex Health – Mexico expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. In particular, Mexico has seen dramatic improvements in life expectancy (of more than 17 years) and a steady decline in infant mortality rates. Nonetheless, at just above 75 years life expectancy, Mexico falls six years below the OECD average of 81 years, and shows the lowest life expectancy in the OECD. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked "How is your health in general?" almost 66% of people in Mexico reported to be in good health, less than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Results-based financing to increase coverage
Mexico introduced public health insurance (Seguro Popular) in 2002, which has contributed to universal financial risk protection. However, effective coverage is low for chronic diseases, with only 26% of adult men and 30% of adult women having access to preventive care. To address this challenge, the state of Hidalgo’s Seguro Popular designed a results-based financial incentive scheme in 2014 to improve performance of key service outputs and health outcomes.
With the results-based financing, providers receive an annual bonus or deduction on expected Seguro Popular subsidies based on their performance in 20 primary care and 5 hospital care indicators, including: diabetes, cardiovascular health, prenatal care, breast cancer screening and the reduction of preventable surgery and hospital readmissions, among others. Indicators were designed based on the best evidence of likely health impact, on the feasibility of implementing the scheme and provider performance monitoring. Annual performance targets were defined using an expert panel to assess the provider’s capacity to increase performance based on their degree of control over resources and outcomes. The size of the incentive fund was estimated at 10% of the payer’s budget. The monitoring system was designed to make use of existing information and information systems in accessible formats.
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nld Health – Netherlands expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in the Netherlands stands at 82 years, one year above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked "How is your health in general?" 75% of people in the Netherlands reported to be in good health, more than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Mental health support
The Dutch government funds mental health professionals to help general practitioners (GPs) to better recognise and treat mental illness. These mental health professionals provide problem analysis and screening; develop and discuss treatment plans; offer psycho-education; support self-management; and conduct interventions for behavioural change, indicated prevention, and relapse prevention. Final treatment and referrals are then determined by the GP.
The share of GPs seeking assistance from mental health professionals has increased from 11% in 2009 to 34% in 2011 and 62% in 2013. Evaluations show that 90% of GPs rate their experience as good or excellent. Patients also report positively on their experiences with the mental health professionals. Both GPs and patients value the professional, quick, low-threshold support provided. Potential for improvement includes greater transparency and familiarity with patients and better integrating mental health professionals in local care teams.
Long-term study on health
The region of the North of the Netherlands faces a shrinking population and an ageing society. Local government has created a major health database to investigate why some people develop chronic illness relatively early in life, while others remain vital and healthy into old age. This investigation will span 30 years, monitoring 165 000 residents of the Northern Netherlands from youth through parenthood to old age. This pioneering three-generation study involves an unprecedented number of life aspects, from heredity and lifestyle to physical and social factors. Participants are called in for an examination once every five years. During this examination, they are asked to complete detailed questionnaires about their medical records, their habits, including diet, smoking, lifestyle, use of medicines, etc. The baseline phase has just been completed and the follow-up phase is about to start.
The results are expected to lead to a faster identification of diseases, discovering new treatments and even preventing chronic disorders. The challenge of staying healthy longer through innovation calls for fundamental breakthroughs in core areas that determine sickness and health, in particular in the fields of life sciences, food and nutrition, medical technology, care and cure and healthy lifestyles.
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nzl Health – New Zealand expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in New Zealand stands at 82 years, one year above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked "How is your health in general?" 86% of people in New Zealand reported to be in good health, much more than the OECD average of 68% and one of the highest scores across the OECD. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
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nor Health – Norway expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth for the whole population in Norway stands at 83 years, two years above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked "How is your health in general?" 75% of people in Norway reported to be in good health, more than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people’s future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Primary care in Oslo
Several initiatives are underway in Oslo to respond to the challenge of meeting evolving primary health care needs.
Oslo has a GP-run, 32-bed, urgent care unit with the aim of avoiding admission to hospital for patients with a known diagnosis. The urgent care unit runs in parallel to a primary care emergency service (PCES) that runs a Clinical Decision Unit (CDU). Here, patients can stay up to 24 hours before decision to admit or to send home must be taken. Around 20% are admitted; Oslo municipality estimates that this figure would be around 80% without the CDU. Oslo's emergency primary care unit also offers emergency social services such as arranging accommodation for homeless individuals or counselling for victims of assault. Around 23 000 contacts per year are made, signalling a huge demand. Finally, Oslo has an innovative unit where elderly can self-refer for nursing care. Patients often self-refer for social care and occasionally for clinical care as well (for example when they have flu-like symptoms). The unit is nurse run and patients can be referred onward for specialist clinical care if needed. This has proved popular and anecdotal evidence states that patients who have been once are reassured by its presence and tend not to overuse.
Accelerating diagnosis
Norway's Oslo University Hospital has greatly reduced the waiting time for breast cancer diagnosis to lessen patient levels of anxiety and uncertainty. The hospital used design-driven innovation methods to identify logistical and organisational inefficiencies and improve workflow. Previously women had to wait up to 12 weeks to find out if their tumour was malignant or benign. The waiting time has since been reduced by 75% (or 48 hours).
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pol Health – Poland expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Poland stands at 78 years, three years below the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked "How is your health in general?" 60% of people in Poland reported to be in good health, less than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
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prt Health – Portugal expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Portugal stands at 82 years, one year above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked "How is your health in general?" almost 50% of people in Portugal reported to be in good health, much less than the OECD average of 68% and one of the lowest scores in the OECD. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Facilitating collaboration to find innovative solutions
Based in Portugal, Patient Innovation is an online platform and social network that brings patients and caregivers together to create and share health-related solutions. Founded in 2014, Patient Innovation has led to the creation of over 650 solutions from over 40 countries. People from across the world are able to use this platform to share their ideas to overcome health challenges with others and improve their overall quality of life. Beyond the site, the Patient Innovation team brings these solutions to meetings with health professionals and the scientific community and shares them more broadly via social media. Medical doctors, engineers, and communication and marketing experts support innovators to ensure their ideas and prototypes come to fruition. Other users can then comment on and rate these solutions for quality. Examples include Ostom-I, a device developed by a user with Crohn’s disease that warns patients when their ostomy bag is nearly full.
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rus Health – Russia expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in the Russian Federation is 73 years, eight years below the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked "How is your health in general?" only 43% of people in Russia reported to be in good health, much less than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people’s future health care use. Gender, age and social status may affect answers to this question.
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svk Health – Slovak Republic expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in the Slovak Republic stands at almost 78 years, three years below the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked "How is your health in general?" just above 65% of people in the Slovak Republic reported to be in good health, less than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
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svn Health – Slovenia expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in Slovenia stands at almost 82 years, slightly above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked "How is your health in general?" almost 67% of people in Slovenia reported to be in good health, slightly lower than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question
Better Policies for Better Lives
Improving teen mental health
"This is Me" is the largest youth counselling web portal in Slovenia and provides teenagers with a friendly, simple, fast, free, and anonymous public access to expert information and problem-solving assistance. Most users are between the ages of 13 and 18. The programme focuses on development of positive mental health, with emphasis on self-image, social and life skills.
Today the network of web counsellors includes 38 experts (medical specialists, psychologists, social pedagogues, social workers, and teachers), who are volunteers from 12 different institutions. Over the course of ten years, experts have answered almost 21 000 questions about dilemmas and problems faced by teens. Although the main aim of these targeted initiatives was not to reduce stigma towards people with mental health problems, reduced stigma remains one of the expected outcomes of the programmes.
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esp Health – Spain expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Spain enjoys one of the highest life expectancies among OECD countries at nearly 84 years, three years above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked "How is your health in general?" just above 75% of people in Spain reported to be in good health, more than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
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swe Health – Sweden expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth for the whole population in Sweden stands at 83 years, two years above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked "How is your health in general" 76% of people in Sweden reported to be in good health, more than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people’s future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Integrated health services for better outcomes
Sweden takes an interdisciplinary approach to good health by providing integrated medical and vocational rehabilitation. Navigator Centres were piloted in 2005-07 as a one-stop shop to offer young people aged 16-25 co-ordinated employment, education and health support. The integrated approach of these centres helps young people enter the labour market while addressing mental health and educational challenges. Clients can access educational and vocational counselling, preventive health care, and mental health services. Though evaluations are not yet available, evidence from the first pilot suggests this is a good model for co-ordinated services. Between 45% and 70% of the 2 000 young people placed in the centres have moved on to education, employment or work experience.
Programme DELTA was established to meet the diverse needs of the Swedish working population. It focuses on employment challenges related to mental ill-health, musculoskeletal disorders, social problems and long-term work incapacity. DELTA facilitates financial co-ordination between the national employment service, the regional health authority, the municipal social service and the national social insurance department to support medical and vocational rehabilitation. These rehabilitative activities aim to shorten patient treatment, speed up return-to-work, and avert sickness absence and social exclusion. Evaluations show the programme has had success in reintegrating workers with 8 out of 10 unemployed participants gaining and maintaining employment and 2 out of 3 were no longer sick-listed.
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che Health – Switzerland expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Switzerland enjoys one of the highest life expectancies among OECD countries at almost 84 years, three years above the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked "How is your health in general?" 81% of people in Switzerland reported to be in good health, much more than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Helping employees return to work
Helsana, the largest private health insurer in Switzerland, provides prevention and reintegration services for employees suffering from mental health problems. Companies are offered support to develop a healthy work environment through the assessments of risk factors (including factors that can generate mental health problems) and the development of a prevention plan. Helsana also provides case management for employees who face difficulties in returning to work after an accident or sickness, when requested by either the employer or the employees themselves. There are no statistics on the number of companies making use of these services offered by Helsana, but anecdotal evidence suggests that mainly companies with high costs due to high absence rates, high staff turnover, high health care costs or recruitment problems are interested in their insurer's prevention and reintegration services.
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tur Health – Türkiye expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Among OECD countries, Türkiye registered one of the greatest gains in life expectancy between 1960 and 2008, with an overall increase in longevity of 25 years, rapidly narrowing the gap with the average across OECD countries. Life expectancy at birth in Türkiye stands at almost 79 years, two years below the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked "How is your health in general?" almost 67% of people in Türkiye reported to be in good health, just below the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
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gbr Health – United Kingdom expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in the United Kingdom stands at 81 years, in line with the OECD average. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked "How is your health in general?" 73% of people in the United Kingdom reported to be in good health, higher than the OECD average of 68%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Performance-based payment incentives to discourage smoking
England piloted a programme of “payment-by-results” contracts with smoking cessation services in 2010 as part of an approach to apply performance incentives to broader parts of the health service. The programme aims increase both the uptake of high-quality smoking cessation services and the supply of stop-smoking services. Contracts were made with Natioanl Health Service (NHS) providers, third sector charities and private providers (such as pharmacies), for services including assessment, counselling and follow-up.
The payment incentive varied slightly between contracts and schemes, but the principle of the programme is that providers receive an initial payment for the service, followed by further payments if the client has not started smoking again within a set follow-up period. In one scheme, a bonus payment of GBR 30.50 was made for each new client accessing the service. The client then has their smoking status recorded four weeks after their “quit date” (whether the person has quit smoking or not), and a further GBR 30 bonus is given for every person who has quit after four weeks. An additional bonus of GBR 50 is made for every person who is still not smoking after 12 weeks. A carbon monoxide (CO) monitor is used to confirm if people have quit smoking.
Addressing health inequalities
The London Borough of Islington introduced the Seasonal Health Interventions Network (SHINE) to address fuel poverty, excess winter deaths and hospital admissions. SHINE is a referral network, providing access to over 25 different seasonal health interventions including advice on affordable warmth, benefit checks, home energy efficiency visits, and support to help people stop smoking. It targets hard-to-reach and hardly-reached residents in the borough to help those most in need of support.
The number of Islington residents receiving support for energy efficiency increased by over 400% after the programme was introduced. An evaluation of the project in 2011 found that 60% of clients were unaware of the services they accessed prior to being referred by SHINE and 89% found the service useful. Following feedback, SHINE added new services including debt and financial advice referrals, handyperson services and home security.
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usa Health – United States expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in the United States stands at almost 79 years, two years below the average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked "How is your health in general?" 88% of people in the United States reported to be in good health, much more than the OECD average of 68% and one of the highest scores across the OECD. Despite the subjective nature of this question, answers have been found to be a good predictor of people’s future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Mental health at work
Employee Assistance Programs (EAPs) offer employees confidential services to help them overcome personal problems that affect their work performance. EAPs give employees access to services and referrals for mental health, addictions, and family counselling; wellness and health promotion; and work-related supports such as career counselling. Typically these services are available 24 hours a day and family members can also benefit from these services. Managers are encouraged to learn how to handle mental ill-health effects on productivity, sickness absence, stress and addictions in the workplace. EAPs are mandatory for federal agencies while private sector coverage is around 65% among companies with more than 100 employees. Evaluations show a decrease in absenteeism, greater employee retention, and significantly reduced medical costs related to early interventions in mental health issues.
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zaf Health-South Africa expand
Key Findings
Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. Life expectancy at birth in South Africa stands at only 64 years, seventeen years below the OECD average of 81 years. Higher life expectancy is generally associated with higher health care spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors).
When asked, "How is your health in general?" fewer people in South Africa reported themselves to be in good health than the OECD average of 69%. Despite the subjective nature of this question, answers have been found to be a good predictor of people's future health care use. Gender, age and social status may affect answers to this question.
Better Policies for Better Lives
Mobile health
Project Masiluleke capitalises on mobile technology to educate people about HIV/AIDS. They send out nearly 1 million messages per day with information about HIV/AIDS prevention and treatment. By reaching a greater number of people than through traditional methods, the project increases awareness and increases the volume of people that are screened for HIV/AIDS.